Going With the Flow
Womens Health
Hormonal changes impact women daily—natural practitioners can assist vibrant women to live their best lives.
Women don’t actually feel their hormones surging or retreating, but they sure do feel the symptoms. For some, those symptoms may be simply attributed to stress, over exercise, or a meal that is disagreeable.
Symptoms of hormonal fluctuations at any stage in a woman’s life vary widely, and unlike in conventional medicine, there isn’t or should not be a “one size fits all” supplement regimen. For example, one 30-year-old woman’s pre-menstrual symtpoms may be completely different than those of another 30-year-old, as well as intensities. Some women experience debilitating uterine cramps, while others expereience no cramps but intense headaches. And, the suite of symptoms during childbearing years often changes in the same woman.
New York-based practitioner and educator, Amber Lynn Vitale, BA, CN, LMT, noted that in childbearing years, symptoms of PMS (premenstrual syndrome) that are not so obvious can include acne or other skin conditions such as rosacea. Also less commonly associated symptoms can include heightened anxiety and depression.
These symptoms, she said, reflect an inability to process both endogenous and exogenous toxins. Endogenous toxins are produced normally as byproducts through cellular function as well as digestion of food. But exogenous overload (overly processed, nutrient-depleted foods, birth control pills and other medications, and environmental endocrine disruptors) can disrupt the delicate normal balance.
In ayurveda, Vitale pointed out, the reproductive system is the last tissue to be nourished. “If the other tissues have a high demand due to stressful factors, the reproductive system misses out. This can be seen all across the animal kingdom—stressed animals do not reproduce. Or if they do, mistakes or defects happen.”
She added that a younger woman’s microbiome is affected by all of endogenous and exogenous toxins. An imbalanced microbiome is shifted in the favor of hosting pathogenic instead of beneficial microbes, “and pathogenic microbes are not engaged in activities that create beneficial hormones or promote positive hormonal conversions and detoxification.”
According to women’s health expert Sara Gottfried MD, New York Times bestselling author of The Hormone Reset Diet and The Hormone Cure, most younger women feel hormonally on track, as they experience a predictable cycle characterized by normal estrogen and progesterone levels. “Progesterone is key to women’s ability to roll with the punches. In the brain, progesterone makes allopregnanolone which interacts with GABA and serotonin for a foursome that truly soothes the female brain,” she described.
A common hormone imbalance in childbearing-aged women, said Dr. Gottfried, is premenstrual syndrome (PMS), which she stated may be an issue of progesterone resistance, according to latest research.
Production of many hormones (estrogen, progesterone and testosterone) begins to decline when in a woman’s latter 20s or 30s—and often in the case of polycystic ovary syndrome, testosterone climbs. “Based on the latest figures, excess androgens in PCOS is present in 30 percent of women of childbearing age,” cited Dr. Gottfried. “With PCOS, we also commonly see insulin and leptin resistance.”
Holly Lucille, ND, RN, author of several books including Creating and Maintaining Balance: A Women’s Guide to Safe, Natural, Hormone Health, said she sees women dealing with uterine fibroids, endometriosis and ovarian cysts as well as for PMS. Dr. Lucille also blames “the overarching influence of our chemically dependent society. After all, we are the first generations to be exposed in a way which we never have seen before and it is making a difference with our bodies, especially the endocrine system,” she said.
There is a range of nutritional protocols our experts would suggest. For women concerned about reproductive balance, Vitale likes herbal adaptogens. That said, she noted, most herbal and nutritional therapies employed may not necessarily address the fundamental hormonal imbalance problems. In fact, “as we discovered through early microbiome research and applied to functional medicine more than a decade ago, it is not beneficial to treat the body with hormones or hormone-balancing nutraceuticals without first balancing the gastrointestinal microbiota,” she stated. Today, many women are dealing with high levels of toxins that may render herbal tonics and adaptogens somewhat powerless. In practice, Vitale offered, women who may have heavy toxic exposures should first be recommended to engage in cleansing, then restore nutrients and gut flora, before implementing a serious adaptogen protocol. Adaptogenic herbs, like ashwagandha, often are contraindicated in traditional herbal pharmacopeia during states of high toxicity.
After cleaning the diet from sugars, flours, and processed foods that selectively nourish pathogenic bacteria, suggest implementing a cleansing protocol that supports all organs in detoxification: blood/spleen, lymph, lungs, skin, urine/kidneys, bile/liver and gastrointestinal tract, Vitale recommended.
After your patient/client reveals she is experiencing higher levels of waste moving out of all elimination pathways, probiotic and pre-biotic therapy can include researched strains that have demonstrated positive health benefits for females like L. rhamnosus and L. reuteri, NCFM L. acidophilus, L. helveticus, B. longum. “Providing prebiotic fibers from organic plants lowers the toxic load in a myriad of overlapping ways, and is crucial to gastrointestinal health that leads to hormonal health,” Vitale explained. From this point on, any herbal or nutraceutical protocol implemented will be much more effective. “And many of the hormonal problems like PMS, skin issues, and mood fluctuations will have already improved before using any other therapies.”
Dr. Lucille completely agrees with this protocol and the reason behind it, noting that from a nutritional and lifestyle perspective, “I think it is about reducing exposure and encouraging healthy hormonal balance and estrogen detoxification.” Because estrogen is metabolized through the liver, which is also burdened with processing xenoestrogens and exogenous estrogens (oral contraceptives and hormone therapy), proper detoxification is important. “Eating a plant-strong, nutrient-dense and organic diet is one of my strongest recommendations. Also animal proteins should be as clean as possible and free of additives and growth hormones.”
Supplements Dr. Lucille likes to recommend to women to encourage healthy estrogen metabolism include DIM, flax seeds, tri-methyl-glycine, glutathione and liver support such as milk thistle. For women who live high-stress lifestyles, progesterone is often called upon as cortisol if needed, leading to a major imbalance in the progesterone/estrogen ratio. In this case, Dr. Lucille said she likes to recommend adrenal support and progesterone-inducing herbs such as vitex.
From a supplement formulator’s perspective, Leonid Ber, MD, science and technology manager, Protocol for Life Balance, Illinois, maker of Herbal Menopause (EstroG-100), explained, “We realize that women and their physicians often want to limit their exposure to phytoestrogens. This aspect of the formula is critically important to those with higher risk of estrogen-associated conditions (i.e. family history of breast tumors). The task of creating efficacious but completely estrogen-free product is challenging but not unattainable,” he commented.
Also in a woman’s latter childbearing years, anytime between age 35 and 50, symptoms emerge that may be confused with PMS, but signal peri-menopause, the years of “hormonal upheaval” prior to the final menses—menopause itself is typically determined to be one full year after that event, according to Dr. Gottfried. Differentiating symptoms from PMS include trouble sleeping/insomnia, night sweats, decreased energy, difficulty in maintaining weight or gaining stubborn pounds around the midsection, increased events of mood swings and irritability not around the menses, and unpredictable periods.
She explained that during this time, “Other hormones also start to fade or deregulate—a peri-menopausal woman’s ovaries, thyroid and adrenals start to work against her, not for her. And, to confuse matters even further, the brain becomes less responsive to the hormones that her body does still produce. There are two phases to perimenopause: phase 1 is when progesterone drops and estrogen fluctuates wildly (overall higher in level) because the feedback loops don’t work, and phase 2 is when both estrogen and progesterone drop.”
She recommends the following supplements: Cortisol Manager (at night), which contains ashwagandha and phosphatidylserine; up to 400 IU vitamin E to mildly reduce mood swings, hot flashes and vaginal dryness; magnesium and/or red ginseng to reduce fatigue and hot flashes; maca to battle insomnia and mood/cognitive issues and to improve BMI (body mass index) and bone density; and Pueraria lobata, a traditional Chinese herbal remedy for overall symptom support.
Protocol for Life Balance recently launched its verified phytoestrogen-free Herbal Menopause (EstroG-100), which contains a clinically validated combination of Phlomis umbrosa, Cynanchum wilfordii and Angelica gigas Nakai extracts, which, according to Dr. Ber, individually and as a combination exhibit no adhesion to estrogen receptors in vivo. Additionally, when it was used in the clinical trial, there was no change in the FSH (follicular stimulating hormone) and estradiol levels among the women consuming both the supplement and placebo, demonstrating its phytoestrogen-free nature. “As such, the product offers [an] excellent alternative to soy isoflavones and black cohosh,” he said.
According to Dr. Ber, Herbal Menopause (EstroG-100) was shown to alleviate symptoms of menopause and peri-menopause such as hot flashes, night sweats, nervousness, occasional sleeplessness, and difficulty in maintaining positive mood. “In fact, 50 percent of women taking the supplement experienced improvement in at least one menopausal symptom within seven days of use, with 75 percent experiencing improvement in at least one menopausal symptom within 14 days,” he reported.
The company also offers the topical product, Liposomal Progesterone Cream, available in unscented and lavender, each delivering 20 mg of natural progesterone (USP) per pump without artificial colors, fragrances or parabens. It contains complementary herbs such as angelica, chamomile, and lemongrass. “Although not verified as a phytoestrogen-free product, Progesterone Liposomal Cream is typically used by women in post menopause with significant rate of success,” Dr. Ber said.
A common occurrence during peri-menopause and post-menopause is the development of breast cysts, which are benign. According to Dr. Gottfried, cyst development is typically spurred by hormonal imbalances. “Estrogen stimulates breast cells to grow, while progesterone prevents cysts from developing in painful breasts. Because estrogen and progesterone have opposing yet interdependent effects, balance between them is crucial. The potential for breast cysts increases during perimenopause due to higher estrogen levels and lower progesterone levels. Balancing your estrogen levels can help to prevent the occurrence of breast cysts.”
Although PMS and peri-menopausal symptoms are certainly both uncomfortable and disruptive, reasonably healthy women may be led through practitioner knowledge and supplementation to dramatically reduce severity and frequency of symptoms, greatly increasing overall quality of life.
For More Information:
Sara Gottfried, MD, (888) 893-6586, www.saragottfriedmd.com
Holly Lucille, ND, RN, (323) 658-9151, www.drhollylucille.com
Protocol For Life, (630) 545-9098, www.protocolforlife.com
Amber Lynn Vitale, (865) 936-1545, www.amberlynnvitale.com
